Correlation between transforming growth factor-β1 (TGF-β1) with premature atherosclerosis in type 1 diabetes

BACKGROUND: Type 1 diabetes (T1D) carries a significant risk of atherosclerosis as the main driver for cardiovascular events. Atherosclerosis is initiated by the activation of the endothelium by various risk factors through the inflammation process. The anti-inflammatory cytokine TGF-β1 may inhibit the development of atherosclerosis. METHODS: In a cross-sectional study, a total of 40 patients aged 14.5±3.16 years old with T1D and 40 healthy controls aged 14.7±0.99 years old were involved. Common carotid artery IMT (cIMT) was measured by real-time M-echocardiography mode (Affinity 50G Philips) and Flow Mediated Dilatation (FMD), using high-resolution ultrasonography and Doppler flow characteristics. The TGF-β1 level was measured by indirect ELISA at Saiful Anwar Hospital Laboratory. RESULTS: There were no differences in age, gender, Body Mass Index (BMI), duration of diabetes, renal function, or nutritional status between the T1D and healthy groups (p>0.05). A significant difference in cIMT was observed between the T1D group and the healthy group (0.567 ± 0.87 mm vs. 0.387 ± 0.57 mm, p = 0.000), FMD (7.17 ± 3.98 mm vs. 11.22 ± 5.48 mm, p = 0.000), and the level of TGF-β1 cytokine (39.83±13.51 vs. 73.67±15.34 pg/ml, p = 0.000). A significantly negative correlation between TGF-β1 and cIMT (p = 0.000; r =-0.685) and a significantly positive correlation between TGF-β1 and FMD (p = 0.000; r = +0.55) were found. CONCLUSION: Atherosclerosis is an inflammatory disease accelerated by diabetes. The inflammation process is more prominent in T1D patients. T1D patients show a decreased level of TGF-β1, increased measurement of cIMT (>0.5 mm), and a decreased measurement of FMD.